Equine Arthritis | Horse Veterinary Library | Cave Creek Equine

Equine Arthritis

Arthritis, often called degenerative joint disease (DJD), is a condition that afflicts many horses. Arthritis is not only painful, but makes it difficult for a horse to move about. The condition is normally characterized as a slowly developing chronic disease of the joint in which the joint surface (cartilage) wears down, resulting in pain and subsequent lameness.

Arthritis is a continual process of inflammation and damage that can not be reversed, but can be slowed. This condition is often an inevitable change as a horse grows older, and often is the reason for a horse to be retired from riding.

Causes

  • Trauma to the joint (i.e. hard work over the years)
    • Acute injury
    • Long term wear-and-tear
    • Developmental disease like OCD
    • Bone chips
  • Wound and infection (septic arthritis)

Symptoms and Types

  • Stiffness that a horse can usually warm out of
  • Joint swelling (can be one or more joints). Common joints to see arthritis are the fetlock, carpus (knee), and hock.
  • Lameness

Bone chips can be a cause of progressive arthritis if not removed shortly after they develop. A simple arthroscopic surgery can be performed to remove these bone chips. If removed early, long term arthritis can be avoided.

Abnormalities in conformation of the limbs can also cause arthritis by producing abnormal forces on the joints.

Diagnosis

Physical examination and a lameness exam. Sometimes radiographs (x-rays), ultrasound or MRI are used to assess the severity of the arthritis.

Treatment

  • Oral antiinflammatories- phenylbutazone (bute), firocoxib, or banamine
  • Topical antiinflammatories like Surpass
  • Oral joint supplements containing glucosamine, chondroitin suflate, MSM and hyaluronic acid
  • Injectable joint supplements: Legend and Adequan
  • Injection of corticosteroids and hyaluronic acid directly into the arthritic joint.
  • Injection of IRAP, PRP and/or Stem Cells directly into the arthritic joint
  • Surgery

The oral anti-inflammatories have the advantage that they will reduce inflammation in all arthritic joints. Bute and banamine are safe for long term use as long as they are administered at low doses. They have the potential to cause stomach ulcers and kidney damage if administered at high levels. Firocoxib has been shown to be safer that bute and banamine when it comes to ulcers and kidney problems. It may be a safer option for long term use.Oral Antiinflammatories

Top to bottom: bute tablets and powder, bute paste, Fiocoxib (Equioxx) paste, Flunixin (banamine) paste

There is now a topical anti-inflammatory called Surpass that is applied to the arthritic joint. It penetrates the skin and goes into the joint, where it reduces inflammation only in that area. The main advantage of Surpass is that it is safe on the stomach and kidneys. However, it must be applied 1-2 times daily to be effective.

Oral Antiinflammatories
Top to bottom: bute tablets and powder, bute paste, Fiocoxib (Equioxx) paste, Flunixin (banamine) paste

The oral joint supplements are somewhat controversial in how well they work. Glucosamine is probably the most studied of the oral supplements and it is known to have a mild effect on joint inflammation when administered at appropriate levels (14mg per pound). There is little convincing scientific evidence that oral chondroitin sulfate, MSM and hyaluronic acid have a significant effect on equine joint inflammation.

There are two injectable medications that have been shown to reduce inflammation in arthritic joints, Legend and Adequan. Both are administered monthly, with the legend administered in the vein and the Adequan in the muscle. The advantage of these injections are that they affect all the joints in the horse. These medications are not only good for treating existing arthritis, but may help to slow the development of arthritis in high level performance horses.

A more effective treatment for arthritis is injection of corticosteroids directly into the arthritic joint or intra-articluar injection. Hyaluronic acid is often mixed with the steroid to enhance the anti-inflammatory effect. These injections usually need to be repeated anywhere from every 4 months to once yearly depending on the joint affected, the level of arthritis present, and the desired soundness. The disadvantage of joint injections is that they only affect the particular joint injected. So if there are multiple arthritic joints in your horse, it could mean multiple injections. Generally, these injections are safe and can prolong the useful life of your horse.

The oral joint supplements are somewhat controversial in how well they work. Glucosamine is probably the most studied of the oral supplements and it is known to have a mild effect on joint inflammation when administered at appropriate levels (14mg per pound). There is little convincing scientific evidence that oral chondroitin sulfate, MSM and hyaluronic acid have a significant effect on equine joint inflammation.

There are two injectable medications that have been shown to reduce inflammation in arthritic joints, Legend and Adequan. Both are administered monthly, with the legend administered in the vein and the Adequan in the muscle. The advantage of these injections are that they affect all the joints in the horse. These medications are not only good for treating existing arthritis, but may help to slow the development of arthritis in high level performance horses.

A more effective treatment for arthritis is injection of corticosteroids directly into the arthritic joint or intra-articluar injection. Hyaluronic acid is often mixed with the steroid to enhance the anti-inflammatory effect. These injections usually need to be repeated anywhere from every 4 months to once yearly depending on the joint affected, the level of arthritis present, and the desired soundness. The disadvantage of joint injections is that they only affect the particular joint injected. So if there are multiple arthritic joints in your horse, it could mean multiple injections. Generally, these injections are safe and can prolong the useful life of your horse.

IRAP- Interleukin 1 Receptor Antagonist Protein. An anti-inflammatory protein found naturally in the bloodstream.

The most effective treatment for arthritis to date is injection of IRAP, PRP and/or Stem Cells directly into the arthritic joint. IRAP is basically an anti-inflammatory that exists naturally in the bloodstream. A sample of blood is taken, then incubated overnight and the IRAP is purified out and placed in syringes for injection. Stem Cells can come from various tissue within the horse, with fat being our tissue of choice. A sample of fat is obtained from beneath the skin at the side of the tail-head. This fat is then sent to the lab (we use Vet-Stem) where the stem cells are isolated and placed in syringes for injection. The stem cells are sent to the clinic within 48 hours of the fat harvest, and injected with IRAP into the arthritic joint. The latest research on using stem cells to treat arthritis in horses is very promising.

using stem cells to treat arthritis in horses is very promising.

Surgical treatment may also be of benefit depending on the damage present in the joint. Unhealthy cartilage can become thickened, soft and delicate; called chondromalacia. If trauma to this delicate cartilage continues, it can result in permanent damage to the very specialized joint cartilage. Surgical treatment of chondromalacia can help to repair the cartilage and prevent this permanent damage.

Surgical fusion of various joints can also be performed. For example, surgical fusion of the pastern joint can be performed with a good prognosis for return to athleticism.

Determining the best treatment for an individual horse depends on the joint affected, the severity of the arthritis, the age of the horse, the use of the horse, and the finances available to treat the horse.

Prognosis

A horse with arthritis can be managed with a proper exercise program, medications and supplements, and even direct joint therapy. The extent of the management will vary greatly depending on the age of the horse and the work he is expected to do.

 

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